OrthoInfo Basics

About Your Back

What are the parts of the spine?
Your spine
Understanding how your spine works can help you better
is a complex understand the common causes of back pain.
structure Vertebrae. Your spine is made up of vertebral bones that are
that does a stacked on top of one another. These bones connect to create a
lot. There canal that protects the spinal cord.

are always Spinal cord and nerves. These “electrical cables” travel
through the spinal canal carrying messages between your brain
demands being
and muscles. Nerves branch out from the spinal canal through
placed on your openings in the vertebrae.
spine. Muscles and ligaments. These provide support and stability
for your spine and upper body. Strong ligaments connect your
Your spine holds up
vertebrae and help keep the spinal column in position.
your head, shoulders, Facet joints. Between vertebrae are small joints that help your
and upper body. It gives spine move.

you support to stand up

straight, and gives you Spinal Cord

flexibility to bend and
Facet Joint Vertebra
twist. It also protects your

spinal cord.

Understanding how your

spine works can help you Spinal Nerve

understand why you

Ligament
have back pain. Intervertebral
Disk

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OrthoInfo Basics — About Your Back

What are intervertebral disks?

Intervertebral disks sit in between the In many cases, back pain is related to aging disks.
vertebrae. In children and young adults, disks have a high
water content. As we get older, the disks begin
When you walk or run, the disks act as shock
to dry out and shrink. They lose their ability to
absorbers and prevent the vertebrae from
cushion the vertebrae, which can result in pain.
bumping against one another. They work with
your facet joints to help your spine move,
twist, and bend. Annulus Fibrosus
Nucleus Pulposus
Intervertebral disks are flat and round, and
about a half inch thick. They are made up of
two components. Spinal Nerve
This is the tough, flexible
outer ring of the disk. It helps connect to the
vertebrae.

Nucleus pulposus. This is the soft, jelly-like

center of the annulus fibrosus. It gives the disk
its shock absorbing capabilities.
Spinal Cord

What are the most common causes of back pain?

Back pain is often caused by injury. Just getting older also plays a role in many
back conditions.

Strains and Sprains. The most common cause of back pain is an injury to
the muscles (strain) or ligaments (sprain) that support your spine. Muscle and
ligament fibers can be overstretched or torn. This frequently is the result of
lifting a heavy weight improperly, having poor posture, or being overweight.

Degenerative Spondylolisthesis.
(Spon-dee-low-lis-THEE-sis). Changes from general wear and tear make it
hard for your joints and ligaments to keep your spine in the proper position.
The vertebrae move more than they should, and one vertebra can slide
forward on top of another. If too much slippage occurs, the bones may begin
to press on the spinal nerves.

(continued on page 3)

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OrthoInfo Basics — About Your Back

(Causes of Back Pain — continued from page 2)

Spinal Stenosis. Spinal stenosis occurs when the space around the spinal
cord narrows. This puts pressure on the spinal cord and the spinal nerves.

When intervertebral disks collapse and osteoarthritis develops, your body

may respond by growing new bone in your facet joints to help support the
vertebrae. Over time, this bone overgrowth –called spurs– can lead to a
narrowing of the spinal canal. Osteoarthritis can also cause the ligaments that
connect vertebrae to thicken, which can also narrow the spinal canal.

Disk Degeneration. With age, intervertebral disks begin to wear away and
shrink. In some cases, they may collapse completely and cause the facet joints
in the vertebrae to rub against one another. Pain and stiffness result. This “wear
and tear” on the facet joints is referred to as osteoarthritis. It can lead to further
back problems, including spinal stenosis.

Compression Fractures. Compression fractures occur

when too much pressure is placed on a vertebra and the
front of it cracks and loses height. This may happen with
a very hard fall or other traumatic injury. More often, compression fractures are
due to osteoporosis, a condition that weakens bone. The thinning bone may even
break with everyday activity.

In severe cases of osteoporosis, especially in the elderly, the vertebra bone

completely collapses. Multiple fractures like these cause a severely rounded back.

Herniated Disk. A disk herniates when the nucleus pushes against a

weakened annulus, causing it to bulge outward. This puts pressure on the
nerves and causes pain. If the annulus is very worn or injured, the jelly-like
nucleus may squeeze all the way through.

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OrthoInfo Basics — About Your Back

For more information

For more information about your spine and common causes of back pain, visit OrthoInfo at
www.orthoinfo.org.

OrthoInfo is the patient education website of the American Academy of Orthopaedic Surgeons
(AAOS), and is a trusted source of information about musculoskeletal conditions. Our articles are
developed by orthopaedic surgeons, and provide detailed information about a wide range of injuries
and diseases, as well as treatment options and prevention topics.

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein.
This information is provided as an educational service and is not intended to serve as medical advice.
Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic
surgeon.

© 2019 American Academy of Orthopaedic Surgeons